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研究表明推进避孕能减少产妇死亡

Study Says Meeting Contraception Needs Could Cut Maternal Deaths by a Third
研究表明推进避孕能减少产妇死亡

A new study by researchers at Johns Hopkins University shows that fulfilling unmet contraception demand by women in developing countries could reduce global maternal mortality by nearly a third, a potentially great improvement for one of the world’s most vulnerable populations.

约翰·霍普金斯大学(Johns Hopkins University)研究人员的一项新研究表明,若能使发展中国家妇女未被满足的避孕要求得到满足,全球产妇死亡率将减少近三分之一,对于这个世界最弱势的群体之一来说,这可能是个巨大的进步。

The study, published on Tuesday in The Lancet, a British science journal, comes ahead of a major family planning conference in London organized by the British government and the Bill and Melinda Gates Foundation that is an attempt to refocus attention on the issue. It has faded from the international agenda in recent years, overshadowed by efforts to combat AIDS and other infectious diseases, as well as by ideological battles.

周二,英国科学杂志《柳叶刀》(The Lancet)上发表了这篇研究报告。此后,英国政府与比尔和梅琳达·盖茨基金会(Bill and Melinda Gates Foundation)在伦敦组织了一个大型计划生育会议,试图使人们重新关注这个问题。近年来,更引人注目的事情是对抗艾滋病以及其他传染性疾病的行动,再加上意识形态斗争,这样一来,国际社会对节育问题的关注逐渐减少。
 

新德里一所医院的妇产科。联合国在2011年统计,世界人口将会继续维持增长势头。

The proportion of international population assistance funds that went to family planning fell to just 6 percent in 2008, down from 55 percent in 1995, while spending on H.I.V./AIDS represented 74 percent of the total in 2008, up from just 9 percent in 1995, according to Rachel Nugent, a professor of global health at the University of Washington, who cited figures from the United Nations Population Fund.

华盛顿大学(University of Washington)的全球健康教授雷切尔·纽金特(Rachel Nugent)援引联合国人口基金会(United Nations Population Fund)的数据称,用于计划生育的国际人口援助基金份额已经从1995年的55%下降到了2008年的区区6%,而用于艾滋病(H.I.V./AIDS)防治的资金份额则从1995年的9%上升到了2008年的74%。

But population growth has continued to surge, with the United Nations estimating last year that the world’s population, long expected to stabilize, will instead keep growing. Population experts warn that developing countries, particularly those in sub-Saharan Africa, where fertility continues to be high and shortages of food and water are worsening, will face deteriorating conditions if family sizes do not shrink.

但是世界人口增长势头仍然迅猛。长期以来,人们都估计世界人口会保持稳定,联合国(UN) 去年预计,恰恰相反,世界人口将持续增长。人口专家发出警告,发展中国家,特别是撒哈拉沙漠以南的非洲国家生育率居高不下,而食物和水源日益短缺,如果这些地区的家庭规模没有减缩,情况将会进一步恶化。

“Family planning kind of faded from the radar screen, and now it is coming back,” said John May, a visiting fellow at the Center for Global Development.

全球发展中心(the Center for Global Development) 的访问学者约翰·马伊 (John May)说:“计划生育本来已经快要从雷达屏幕上消失了,现在却又卷土重来。”

The issue of family planning is fraught in the United States, where government assistance often gets caught up in political battles. Contraception has again become controversial this political season, though the United States remains a major donor.

美国对计生问题十分担忧,政治斗争经常使政府的援助计划陷入僵局。虽然美国仍然是一个主要捐赠国,但是在这个政治时节,避孕问题再一次引发了争议。

The Gates Foundation and the British government are pressing the issue. About $4 billion is expected to be pledged at the London conference to provide family planning services to 120 million women from the world’s poorest countries over the next eight years.

盖茨基金会和英国政府正在推进这个问题。这次的伦敦会议有望筹措到大约40亿美元,在接下来的8年中,人们将会用这笔钱为世界最贫穷国家的1.2亿名妇女提供计划生育服务。

“We hear time and again from women out in the field that they want the ability to plan their families,” said Gary Darmstadt, director of family health at the Gates Foundation. “We felt we needed to shine a light back onto the importance of this issue and get the conversation going.”

“我们多次听到落后地区的妇女说,她们希望拥有自主安排生育的能力。”盖茨基金会主管家庭健康的加里·达姆施达特(Gary Darmstadt)说。“我们觉得我们需要重新关注这件事情,让这个话题继续下去。”

Maternal deaths have declined dramatically since 1990, down by a third, according to the World Health Organization.

世界卫生组织(World Health Organization, or WHO) 表示,1990年以来,产妇死亡率降低了很多,比原来减少了三分之一。

But about 16 percent of the world’s population lives in countries where fertility is still more than four children per woman, Mr. May said. The numbers of people are expected to more than triple in these places during this century.

然而,大约有16%的世界人口生活在生育率仍为每名妇女生育超过四个孩子的国家,马伊说。本世纪,这些地区的人口数量将增加两倍还多。

The Lancet study, which the Gates Foundation financed, draws on maternal mortality and survey data from the United Nations and World Health Organization to estimate the annual number of maternal deaths in 172 countries and the share that could be preventable by the use of contraception.

《柳叶刀》上的研究报告运用了UN和WHO的产妇死亡率和调查数据,以估算172个国家每年产妇死亡总数和依靠避孕手段能避免的产妇死亡比例。盖茨基金会为这项研究提供了经费。

Birth control reduces health risks, the researchers said, by delaying first pregnancies, which carry higher risks in very young women; cutting down on unsafe abortions, which account for 13 percent of all maternal deaths in developing countries; and controlling dangers associated with pregnancies that are too closely spaced.

研究人员表示,采取避孕手段会减少健康风险,它能推迟对年幼女性来说尤其危险的首度受孕,减少不安全的堕胎(发展中国家13%的产妇死亡都是这个原因引起的),控制与怀孕太过频密相关的种种危险。

The authors of the Lancet study, researchers at the Bloomberg School of Public Health at Johns Hopkins, found that the number of maternal deaths in those countries in 2008 would have nearly doubled without contraception. They acknowleged, however, that maternal mortality record-keeping is weak in developing countries, a limitation of the study. They also found that an additional 29 percent of the deaths could have been prevented if women who wanted birth control would have received it, a concept called unmet need that is estimated using surveys.

上述研究报告的作者是约翰·霍普金斯大学彭博公共卫生学院的一组研究人员,他们发现,如果没有避孕手段,这些国家2008年的产妇死亡总数将会增加几乎一倍。然而他们指出,发展中国家的产妇死亡率统计并不准确,这是该研究的一个不足之处。他们还发现,如果所有希望节育的妇女都能够享受到节育服务,产妇死亡总数将会再减少29%,这个观念被称作“未被满足的需求”,通过建立在调查基础上的估算得出。

Even so, simply providing contraceptives to people who are not using them and who say they want to avoid pregnancy might not be enough to actually do so, and Professor Nugent said the study’s conclusions might be optimistic.

即便如此,仅通过向没有采用避孕措施和表示希望避免怀孕的人提供避孕用品,似乎还不足以达到目的。纽金特教授说,这项研究的结论也许有些过于乐观。

The lack of birth control in poor countries has become an important issue for Melinda Gates, who argued in highly personal remarks in April that birth control should not be controversial, because it improves women’s lives.

贫穷国家缺少计生用品的状况成了梅琳达·盖茨的心头大事。四月份,她以个性十足的言辞表示,避孕的事情不容争议,因为它能改善女性的生活。

“Somewhere along the way we got confused by our own conversation and we stopped trying to save these lives,” she said. She added: “We’re not talking about abortion. We’re not talking about population control. What I’m talking about is giving women the power to save their lives.”

她说:“路途之中,有时我们会对自己的言论感到迷惑,于是就停住脚步,不再努力挽留这些生命。”她又说:“我们并不是在谈论堕胎,也不是在谈论人口控制。我要说的是,应该给予妇女拯救自己生命的能力。”
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